Despite the recent resurgence of tuberculosis among children in United States, no series infants < 1 year age with has been reported last 20 years. This study was undertaken to describe epidemiology, clinical, and radiographic manifestations, response therapy tuberculous disease.The medical records were reviewed for all 12 months or less a diagnosis cared at Children's Tuberculosis Clinic Ben Taub General Hospital Houston, Texas between January 1, 1985 June 30, 1992.Of 47 identified, 51%...

Tumor necrosis factor (TNF)–α, interleukin (IL)–1β, and nitric oxide (NO) may play a role in lipopolysaccharide (LPS)–induced cardiac depression. Toll-like receptor–4 (TLR-4) mediates the cytokine response to LPS immune cells. TLR-4 also is expressed human murine myocardial tissue. Therefore, hypothesis that induces proinflammatory cytokines heart via was tested. C3H/HeJ (TLR-4 deficient) C3HeB/FeJ mice were studied. induced robust increase TNF-α IL-1β mRNA mice. The blunted delayed....

The innate antiviral response is mediated, at least in part, by Toll-like receptors (TLRs). TLR3 signaling activated to viral infection, and the absence of mice significantly increases mortality after infection with enteroviruses that cause myocarditis and/or dilated cardiomyopathy. We screened patients diagnosed enteroviral myocarditis/cardiomyopathy identified a rare variant one patient as well increased occurrence common polymorphism compared controls. Expression either resulted reduced...

Enterovirus-induced myocardial injury can lead to severe heart failure. To date, little is known about the early innate stress response that contributes host defense in heart. Toll-like receptor 3 (TLR3) important initiation of antiviral response. We investigated involvement TLR3, which recognizes viral double-stranded RNA, on encephalomyocarditis virus (EMCV) infection. examine contribution TLR3 protection from EMCV infection, we infected mice deficient with 50 plaque-forming units EMCV....

The precise molecular mechanisms responsible for sepsis-induced myocardial dysfunction remain undefined. Toll-like receptor-4 (TLR-4) engages lipopolysaccharide (LPS) and activates signaling pathways leading to the expression of proinflammatory cytokines implicated in dysfunction. We determined whether TLR-4 was necessary LPS-induced vivo. effects LPS on left ventricular (LV) function were studied mice with defective (C3H/HeJ, deficient) wild-type (C3HeB/FeJ). Mice ( n = 5/group) injected or...

Previous studies have shown that tumor necrosis factor (TNF) confers cytoprotective responses in cardiac myocytes. However, the mechanisms for effects of TNF remain unknown. Given signals through nuclear kappaB (NF-kappaB) and given NF-kappaB mediates responses, we asked whether activation conferred acute myocardial ischemia/infarction.We examined infarct size prevalence apoptosis transgenic mice harboring cardiac-restricted expression a mutated IkappaBalpha protein (IkappaBalphaDeltaN)...

Background— The molecular mechanisms responsible for sepsis-induced myocardial dysfunction remain undefined. CD14 mediates the inflammatory response to lipopolysaccharide (LPS) in various organs including heart. In this study we investigated role of LPS-induced vivo. Methods and Results— Wild-type CD14-deficient (CD14-D) mice were challenged with Escherichia coli LPS. Myocardial tumor necrosis factor, interleukin-1β (IL-1β), NOS2 induction was measured before 6 hours after LPS challenge....

Production of proinflammatory cytokines contributes to cardiac dysfunction during ischemia-reperfusion. The principal mechanism responsible for the induction this innate stress response periods myocardial ischemia-reperfusion remains unknown. Toll-like receptor 2 (TLR2) is a highly conserved pattern recognition that has been implicated in immune variety pathogens. However, TLR2 may also mediate inflammation noninfectious injury. We therefore hypothesized essential modulating and left...

Acute hematogenous osteomyelitis (AHO) is a severe infection in children. Drainage of purulent collections bones provides specimens for culture as well therapeutic benefit. Interventional radiology (IR)-guided procedures may serve less invasive means select patients. We examined the impact IR and surgically obtained cultures diagnosis management AHO.A retrospective review cases AHO was performed from 2011 to 2014. Patients with chronic disease, orthopedic hardware, puncture wounds, or an...

The Streptococcus anginosus group (SAG, S. anginosus, intermedius and constellatus) are often associated with severe disease abscess formation. In our institution, we observed an apparent increase in frequency of intraorbital intracranial infections resulting from SAG at Texas Children's Hospital. We undertook a retrospective review to describe the clinical features these infections.We reviewed database microbiology laboratory Hospital 2011 2018 for SAG-positive cultures. Cases included were...

Background— Staphylococcus aureus sepsis is associated with significant myocardial dysfunction. Toll-like receptor 2 (TLR2) mediates the inflammatory response to S and may trigger an innate immune in heart. We hypothesized that a TLR2 deficiency would attenuate –induced cardiac proinflammatory mediator production development of Methods Results— Wild-type TLR2-deficient (TLR2D) mice were studied. challenge significantly increased tumor necrosis factor, interleukin-1β, nitric oxide expression...

Background: Bacteremia is often one factor used in deciding the need for prolonged intravenous antimicrobial therapy osteoarticular infections (OAIs). We examined treatment practices and outcomes of Staphylococcus aureus bacteremic (BOAIs) evaluated at Texas Children’s Hospital. Methods: Cases acute hematogenous OAI children with positive blood cultures S. Hospital between 2011 2014 were reviewed. Orthopedic complications included chronic osteomyelitis, growth arrest, pathologic fracture,...

Abstract Background Staphylococcus aureus is the most common cause of acute hematogenous osteoarticular infections (AHOAIs) in children. The risk factors for development orthopedic complications (OC) after AHOAI are poorly understood. We sought to describe clinical and microbiologic variables present on index admission that may predict OC S. AHOAI. Methods cases were identified from 2011–2017 at Texas Children’s Hospital reviewed OC. included chronic osteomyelitis, growth arrest, avascular...

Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge microbiology SA is critical to treatment. Awareness presence attendant AO also important guide clinical management. We sought describe current in children features associated with coexisting AO.Patients were identified from infectious diseases consult service records 2010 2014. Patients penetrating/open trauma orthopedic hardware situ excluded.A total 168 patients...

Background: The Streptococcus anginosus group (SAG) pathogens have the potential to cause head and neck space infections, including intracranial abscesses. Several centers noted an increase in abscesses children during SARS-CoV-2 pandemic, prompting a Centers for Disease Control Prevention health alert May 2022. We examined epidemiology of pediatric at tertiary care center with focus on SAG pre- post-pandemic. Methods: Cases any microbiologic etiology admitted from January 2011 December 2022...

Background: Clindamycin resistance among community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) complicates the management of a challenging infection. Little data exist to guide clinicians in invasive clindamycin-resistant CA-MRSA infections children and studies using oral regimens such as trimethoprim-sulfamethoxazole (TMP-SMX) linezolid for treatment these are limited. We sought reevaluate antibiotic at tertiary children’s hospital. Methods: Cases MRSA were identified...

Background: National data previously demonstrated an increase in invasive disease due to non-type b Haemophilus influenzae from the 2000s 2010s. Significant shifts epidemiology of respiratory pathogens children have occurred post-SARS-CoV-2 era. We examined pediatric H. pre- and years. Methods: Invasive infections were identified culture records Texas Children’s Hospital microbiology laboratory January 2011 December 2023. cases considered those with isolation a sterile site. The annual...

While Staphylococcus aureus is the most common pathogen causing acute bacterial arthritis (ABA), microbiology diverse, particularly in young children. Kingella kingae a well-known of ABA and can be difficult to identify. We examined impact molecular diagnostics on historically methicillin-resistant S. (MRSA) endemic region. Cases children ≤5 years old between 2015 2022 were reviewed. The clinical features cases compared by causative pathogen. Trends utilization rates identification examined....

High-mobility group box 1 (HMGB1) released from necrotic cells or macrophages functions as a late inflammatory mediator and has been shown to induce cardiovascular collapse during sepsis. Thus far, however, the effect(s) of HMGB1 in heart are not known. We determined effects on isolated feline cardiac myocytes by measuring sarcomere shortening contracting myocytes, intracellular Ca2+ transients using fluo-3, L-type calcium currents whole cell perforate configuration patch-clamp technique....

Elevated vancomycin minimum inhibitory concentrations (MICs) in Staphylococcus aureus have been associated with worse clinical outcomes adults. For invasive meticillin-resistant S. (MRSA) infections adults, the Infectious Diseases Society of America recommends targeting serum trough between 15 and 20 μg/mL. We evaluated trends MICs from healthcare-associated (HCA) bacteremia isolates children addition to correlating levels outcomes.Patients were identified a prospective surveillance study at...

ABSTRACT One of the strategies utilized to decrease infections in hospital setting relies on topical antimicrobials and antiseptics. While their use is beneficial, concerns arise over potential develop resistance or tolerance these agents. We examined nosocomial Staphylococcus aureus isolates from 2007 2013 for presence genes associated with chlorhexidine. Isolates patients were identified an S. surveillance study at Texas Children's Hospital. Nosocomial (those causing infection ≥72 h...